Transfusions and Reactions Flashcards
What are the indications for packed red cells?
Hb <70g/L
Hb <80g/L if ACS
How quickly is packed red cells transfused?
1 unit over 2 hours
What are the indications for platelet transfusion?
platelet count <30
platelet count <100 if critical bleeding site such as cranial
What are the indications for FFP?
INR >1.5
Prolonged PT
What is cryoprecipitate?
Factors 8, 13, Von-Willebrand and fibrinogen
What are the indications for cryoprecipitate?
Hypofibrinogenemia <1.5g/L
Massive haemorrhage
DIC
Bleeding in liver failure
When is PCC used?
Warfarin associated haemorrhage
What are the benefits of transfusions?
Symptom relief
Prevent long term complications of anaemia eg heart failure
Prevent bleeding
What does irradiated blood mean? When is it indicated?
T-lymphocytes have been removed with irradiation therefore preventing transfusion associated graft vs host reaction
Hodgkins, neonates, immunocompromised (chemotherapy), bone marrow or stem cell transplant
What are the indications for CMV negative blood?
Neonates
Pregnancy
What are some complications of blood transfusions?
Acute haemolytic transfusion reaction Febrile non-haemolytic transfusion reaction TRALI TACO Anaphylaxis Infection Transfusion associated graft vs host
How would febrile non-haemolytic reaction present?
How should it be managed?
Fever and rigors
Slow/stop transfusion + paracetamol
How is a mild allergic reaction to blood products managed vs anaphylaxis?
Mild: slow/ stop transfusion and give antihistamine
Anaphylaxis: stop transfusion and give IM adrenaline
How does acute haemolytic reaction present?
How is it managed?
Within minutes the patient develops:
- Fever
- Hypotension
- Agitation
- Chest or abdo pain
Stop the transfusion
Send the blood for direct coombs testing and resend a patient crossmatch
Fluid resuscitation
How does TACO present?
How is it managed?
Hypertension
Pulmonary oedema: dyspnoea
Raised JVP
Slow transfusion
Furosemide
